Discussion Topic
Josh has been slightly overweight since grade school, but, as he progressed into the junior high years, his weight grew worse; by the time he graduated high school, he was considered obese. At 20 years of age, Josh has been diagnosed as prediabetic with metabolic syndrome. He has come to the dietitian’s clinic for a consultation.
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“I get really discouraged,” Josh says. “It’s not like I never have will power, and at times I have starved myself for days and spent long afternoons on the treadmill while watching TV. But then I get so hungry that once I start eating I can’t stop. At other times, I work hard at dieting and exercise for so long, but I’m so big that I can’t see any difference. Of course, the stares when I go out in public are depressing, and then I just give up and think, ‘What’s the use? I can’t ever escape my own body,’ and then I give up and turn to comfort food. It’s very discouraging. I feel like I’m living inside my own personal prison.”
On further intake, the nutrition nurse learns that Josh has very tense relationships with his four older brothers, who have sometimes bullied him. “Even when we get along, they make jokes about my size,” he says.
Josh reveals that when he was small, he was not overweight, but he was also not very athletic like his older brothers. He felt separated from them by the fact that he had no interest in or talent for the athletics his brothers constantly engaged in at home.
“Plus I was just a lot younger, and when they’d tease me, I’d cry and my mom would comfort me with treats. As I got heavier when I was older, they’d criticize me for everything I put in my mouth, and if I didn’t eat, they’d sometimes try to be supportive, sometimes indifferent, and at other times, my second oldest brother would say, ‘I know as soon as we’re not looking you’re gonna binge, aren’t you.” It wasn’t my intent, but then when he’d say that, I’d be so angry, I’d do it. The more I did it, the more they harassed me, and it turned to anger on their part as I started to get fat. It just sort of skyrocketed from there. I hate this. I feel so trapped by my own compulsions.”
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The text says, “Health is the merging and balancing of physical, intellectual, emotional, social, spiritual dimensions, and environmental dimensions.”
a. Food, of course, is in the physical health dimension, but how might other dimensions be affecting Josh’s food choices?
b. One of the reasons Josh has often “failed” in the past is that he “starves” himself for long periods and then binges out of intense hunger pangs. The nurse starts to discuss healthy snacking strategies, but he says, “Stop right there. Snacks have been my whole problem. Running to treats out of depression. No, snacks are what make people fat. They make me fat. I want a diet that limits me to three meals a day, or maybe even just two.” How might the nurse counsel Josh?
All posts must contain at least (3) professional references (recency should be in the last 5 years), one may be the course textbook, properly cited in the current APA format.
Textbook Dudek, S. G. (2018). Nutrition essentials for nursing practice. (8th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
SAMPLE SOLUTION
Individual food choices are determined by more than the physical health dimension. In Josh’s case, the dimensions that are playing a significant role in his food choices include the physical, emotional, social, and environmental dimensions. His constant feeling of hopelessness and despair affects his emotional dimension, causing him to look for relief and comfort in unhealthy ORDER YOUR PAPER AT WRITTASK.COM complicated relationship with his family, especially with his brothers, is a stressor that causes him to make the wrong choices, such as binge-eating. Josh’s dieting habits have been among the leading causes of his obesity. The nurse is responsible for offering sound counsel to Josh to help him deal with the issue. First of all, the nurse should emphasize the need for Josh to have consistent healthy meals and avoid starving ORDER YOUR PAPER AT WRITTASK.COM diet should include fiber-rich, fat-reduced, and low-energy density carbohydrates, which is mostly contained in fresh fruits and ORDER YOUR PAPER AT WRITTASK.COM should incorporate some snacking into his regular meals, which can help him deal with the starving periods that cause him to eat unnecessarily. However, the snacks should be made up of healthy and low sugar alternatives…